If currently active duty in the U.S. Military, provide anticipated date of separation/retirement or start of terminal leave (mm/dd/yyyy):Type of Discharge:If retired from the military provide your rank and the date of retirement:If retired because of a service connected disability, transferred to the permanent disability retirement list, or currently receiving compensation for a service connected disability, indicate the percentage of the disability:Date of your last VA letter or other Armed Forces Disability Letter (mm/dd/yyyy):16. Availability Date

If you are applying by the OPM Form 1203-FX, leave this section blank.

17. Service Computation Date

18. Other Date Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

19. Job Preference

If you are applying by the OPM Form 1203-FX, leave this section blank.

20. Occupational Specialties

001 Supervisor Education Program Specialist

21. Geographic Availability

512010153 Quantico, VA

22. Transition Assistance Plan

23. Job Related Experience

If you are applying by the OPM Form 1203-FX, leave this section blank.

24. Personal Background Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

25. Occupational/Assessment Questions:

Please accurately identify your level of experience and demonstrated capability when completing this questionnaire as your responses, resume and supporting documents will be reviewed for accuracy. You will be asked at the end of this questionnaire to certify your entire application as true and accurate.

The following section is used to determine your eligibility for appointment and referral consideration. Please indicate those eligibilities for which you are eligible and would like to be considered. You will only be considered under eligibilities that you select and provide requested supporting documents. If you do not meet at least one of the eligibilities below, you are not eligible to be considered for this position. For additional information, definitions and supporting documentation requirements see the list of appointing eligibilities listed at https://chart.donhr.navy.mil/info/HiringCats.pdf

1. Current Permanent Federal Civilian Employee - I am currently employed as a permanent career or career-conditional (Tenure 1 or 2 in box 24 of SF-50) federal employee in the competitive service within the Washington DC metro area.(SF-50 will show a 1 in box 34). Note: Your resume include your position title, pay plan, series, grade level, agency worked for and dates of employment for all applicable federal work experiences.

A. YesB. Not applicable, OR I do not wish to be considered under this eligibility.

2. Veterans Employment Opportunity Act (VEOA) I am a veteran who served substantially 3 or more years of continuous active duty in the military - OR - I am a preference eligible; AND I was discharged under honorable conditions. Visit http://www.fedshirevets.gov/job/vetpref/index.aspx for veterans' preference eligibility requirements. Ensure that you have answered all applicable veterans’ questions in both the Eligibility Information and Other Information sections of this questionnaire.

A. YesB. Not applicable, OR I do not wish to be considered under this eligibility.

3. I was formerly employed as a permanent federal civilian employee (Tenure 1 or 2 in block 24 of your SF-50) in the competitive service within the Washington DC metro area (SF-50 will show a 1 in block 34) who 1) previously attained career status - OR- 2) is a Veterans' preference eligible and served at least one day as a career conditional employee - OR - 3) separated from civil service as a career-conditional employee within the past three years. I am NOT a current permanent federal employee. Note: Your resume include a work experience with position title, pay plan, series, grade level, agency worked for and dates of employment that supports previous federal employment and your reinstatement eligibility.

A. YesB. Not applicable, OR I do not wish to be considered under this eligibility.

4. I am a current or former federal employee displaced from a position in a Non-DoD federal agency (e.g. IRS, VA, Dept of Labor, ect.) in the same local commuting area of the vacancy. I have a current (or last) performance rating of record of at least fully successful or the equivalent. Applicants eligible under ICTAP are provided priority selection for vacancies with the local commuting area for which they apply and are well qualified. NOTE: if you indicate “yes” for this statement, you must submit copies of the appropriate documentation, such as a reduction in force (RIF) separation notice, SF-50, reflecting your RIF separation, or a notice of proposed removal for declining a directed reassignment or transfer of function to another commuting area. You must also submit documentation to reflect your current (or last) performance rating of record.

A. YesB. Not applicable, Or I do not wish to be considered under this eligibility

5. I am registered in the DoD Priority Placement Program (PPP) Military Spouse Preference Program (Program S) for the series, grade and location covered by this announcement.

A. YesB. Not Applicable

1. Carefully read the following descriptions of experience and/or education. Select the one that best describes your qualifications for the Supervisory Education Program Specialist. Make sure your resume supports your response.

A. I have a degree that included or was supplemented by at least 24 semester hours in a field related to the work of this position, of which at least 9 semester hours must have been in education courses.B. I have a combination of education and experience with at least 24 semester hours in a field related to the work of the position to be filled, of which at least 9 semester hours must have been in education courses, plus appropriate experience or additional education. The experience must reflect the level and kind described in C below.C. I have four years of experience that demonstrated a thorough understanding of the principles and practices underlying the work of this series. This experience must have been of such character and diversity to demonstrate that the applicant possesses an understanding of the field comparable to that normally acquired through successful completion of a full 4-year course of study in an accredited college or university.D. I have at least 1 full academic year of professional teaching experience. This experience is defined as full and primary responsibility, under general supervision, for instruction of assigned students in an accredited school or institution. This includes responsibility for preparing and presenting lessons and for evaluating students' progress, including a determination of the students' success or failure according to established criteria. Serving in an assistant capacity to a professor without the authority to determine the students' success or failure to meet course requirements does not meet this criterion.E. My education and/or experience is not reflected in any of the above statements.

2. To qualify for Supervisory Education Program Specialist GS-12 your qualifications must include: Specialized Experience Statement – I have at least one full year (52 weeks) of specialized experience equivalent in the level of difficulty and responsibility to that of the GS-11 in the Federal Service that has equipped me with the particular knowledge, skills and abilities to successfully perform the duties of the position. Specialized experience is defined as:
Experience conducting research and providing curriculum design in the area of leadership and career development to ensure curriculum is current, relevant and appropriate.
Experience scheduling and coordinating delivery of instruction and course materials with offsite campuses.
Experience establishing an institutional research and effectiveness plan that collects and uses course feedback from instructors, students and graduates to evaluate their effectiveness of the curriculum and making appropriate changes for delivery of future courses

A. YesB. No

3. To qualify for Supervisory Education Program Specialist GS-13, your qualifications must include: Specialized Experience Statement – I have at least one full year (52 weeks) of specialized experience equivalent in the level of difficulty and responsibility to that of the GS-12 in the Federal Service that has equipped me with the particular knowledge, skills and abilities to successfully perform the duties of the position. Specialized experience is defined as:
Experience supervising, managing and applying theories and methodologies in adult learning to include course research, development and curriculum design.
Experience conducting research and providing curriculum design in the area of leadership and career development to ensure curriculum is current, relevant and appropriate.
Experience scheduling and coordinating delivery of instruction and course materials with offsite campuses.
Experience establishing an institutional research and effectiveness plan that collects and uses course feedback from instructors, students and graduates to evaluate their effectiveness of the curriculum and making appropriate changes for delivery of future courses. Experience Developing lesson plans, curricula, and programs with different technologies to enhance the educational experience and increase its effectiveness.

A. YesB. No

4. To qualify for Supervisory Education Program Specialist GS-14, your qualifications must include: Specialized Experience Statement – I have at least one full year (52 weeks) of specialized experience equivalent in the level of difficulty and responsibility to that of the GS-13 in the Federal Service that has equipped me with the particular knowledge, skills and abilities to successfully perform the duties of the position. Specialized experience is defined as:
Experience supervising, managing and applying theories and methodologies in adult learning to include course research, development and curriculum design.
Experience conducting research and providing curriculum design in the area of leadership and career development to ensure curriculum is current, relevant and appropriate.
Experience scheduling and coordinating delivery of instruction and course materials with offsite campuses.
Experience establishing an institutional research and effectiveness plan that collects and uses course feedback from instructors, students and graduates to evaluate their effectiveness of the curriculum and making appropriate changes for delivery of future courses. Experience Developing lesson plans, curricula, and programs with different technologies to enhance the educational experience and increase its effectiveness. Review and approve the substance of reports, decisions, case documents, contracts, or other action documents to assure that they accurately reflect the agency's policies and procedures.

A. YesB. No

For each task in the following group, choose the statement from the list below that best describes your experience and/or training. Darken the oval corresponding to that statement in Section 25 of the Qualifications and Availability Form C. Please select only one letter for each item.

A- I have not had education, training or experience in performing this task.B- I have had education or training in performing the task, but have not yet performed it on the job.C- I have performed this task on the job. My work on this task was monitored closely by a supervisor or senior employee to ensure compliance with proper procedures.D- I have performed this task as a regular part of a job. I have performed it independently and normally without review by a supervisor or senior employee.E- I am considered an expert in performing this task. I have supervised performance of this task or am normally the person who is consulted by other workers to assist them in doing this task because of my expertise.

5. Develop lesson plans, curricula, and programs with different technologies to enhance the educational experience and increase its effectiveness.

22. Coordinate the efforts of personnel within and externally in the performance of near term and long range curriculum planning.

23. Your ratings in this Occupational Questionnaire are subject to evaluation and verification based on the documents and references you submit. Deliberate attempts to falsify or inflate your responses may be grounds for not referring you.
Please respond to each question accurately and ensure your answers are supported by your resume. Failure to agree to the statement below will disqualify you from further consideration for the position.

A. Yes, I verify that all of my responses to this questionnaire are true and accurate, I accept that if my supporting documentation and/or later steps in the selection process do not support one or more of my responses to the questionnaire that my application may be rated low and/or I may be removed from further consideration.B. No, I do not accept this agreement and/or I no longer wish to be considered for this position.